PUBMED (PDF, Jun 2020) Geographical disparities in human papillomavirus herd protection. Source: Cancer Medicine (Cancer Med), Volume, Issue, 2020, ISSN: 2045-7634

Geographical disparities in human papillomavirus herd protection.

Berenson Abbey B AB, Hirth Jacqueline M JM, Chang Mihyun M

© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

2020 Jun 1.

doi: 10.1002/cam4.3125. Online ahead of print.

Geographical Disparities in Human Papillomavirus Herd Protection


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Background: Human papillomavirus (HPV) vaccination has occurred unequally across the United States, potentially contributing to uneven vaccine-type HPV prevalence between regions. We examined whether emerging vaccine-related herd protection exhibits regional differences among unvaccinated girls and women.

Methods: We evaluated the prevalence of vaginal HPV among women 14-59 years of age from 2003 to 2014 using repeated cross-sectional data from the National Health and Nutrition Examination Survey (NHANES). Women who provided an adequate vaginal swab sample were included. Vaginal prevalence of vaccine-type HPV (types 6, 11, 16, 18) were examined in four regions of the United States between 2003 and 2014. We examined vaccine-type HPV prevalence in 2007-2014 in each US census region among younger participants (14-34 years old) stratified by vaccination status to determine whether one or both groups contributed to uneven HPV prevalence.

Results: A total of 12 175 participants 14-59 years of age met inclusion criteria. Vaccine-type HPV prevalence decreased in all regions. Vaccine-type HPV varied by region only among unvaccinated 14-34 year olds, with a higher prevalence in the Midwest (13.8%, 95% confidence interval (CI): 10.7-17.0) and South (12.5%, 95% CI: 10.2-14.8) compared to the Northeast (8.9%, 95% CI: 6.5-11.2). No regional variation in vaccine-type HPV prevalence was observed among vaccinated participants.

Conclusions: Higher prevalence of vaccine-type HPV among unvaccinated women in the South and Midwest may contribute to regional disparities in HPV-related cancer incidence, as emerging herd immunity may not be as strong in those regions.

Keywords: HPV vaccination; geographical disparities; herd immunity; human papillomavirus (HPV).




Published:2020 Jun 01

Created at:

Last revised:2020-06-02

Source:Cancer medicine (Cancer Med), volume , issue , 2020, ISSN: 2045-7634

Publication Country:United States

Publication Type:Journal Article

Keywords:HPV vaccination, geographical disparities, herd immunity, human papillomavirus (HPV)